Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Abstract

BackgroundSoil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health.ObjectivesTo evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.MethodologyA cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.ResultsAmong 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.ConclusionsSTH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research.

Intestinal parasites: Associations with intestinal and systemic inflammation

“…For instance, Sanchez et al,34 found no association between STH and IL‐10 in a study in Honduran children. Also, de Gier et al35, did not find differences in acute phase protein or CRP in Cuban or Cambodian children between infected and non‐infected children with STH.…”

“…The results of the parasitological examination were based on 1 stool sample per child; thus, the number of infected children may be underestimated. However, a single Kato‐katz has been widely used in epidemiological studies such as this one 34, 50. The count of stool leukocytes measures the number of cells which may lead to non‐systematic misclassification and does not differentiate between the different immune cell subtypes.…”

Soil-Transmitted Helminths, Poverty, and Malnutrition in Honduran Children Living in Remote Rural Communities

“…1 Similar to many other countries in Latin America, Honduras is endemic for STH, 6 and these infections have long been recognized by the government as significant public health problems disproportionally affecting children. 7 Currently, these parasitoses are among the nine NTDs targeted for prevention and control at the national level. 8 Yet, despite these efforts and the country's ongoing improvements in major health and social indicators, 9 according to the WHO, almost 800,000 preschool children and almost two million school-age children are still living at risk of infections (http://www.who.int/neglected_diseases/ preventive_chemotherapy/sth/en/).…”

“…Increased prevalence was associated with lower Human Development Index (HDI). 12 Other studies describing the prevalence, health impact, and risk factors of STH infections in Honduran schoolchildren have recently been undertaken in the rural populations 7,13 and across the country's ecological regions.…”

“…Children's nutritional status was assessed through anthropometric indicators, as previously reported. 7 Stunting, underweight, and thinness were determined when children's height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body-mass-index-for-age Z-score (BAZ) were ,-2 standard deviations (SDs) of reference values, respectively. 16 According to the standards, WAZ was calculated only for children #10 years of age.…”